Heritage healing: why historic houses improve wellbeing

With its low gables and sunny verandahs, the empty former cottage hospital of Winsford is a building like no other in the world. The result of a philanthropic dream shared by a rich widow and a leading Victorian architect, in the 119 years since the ailing people of north Devon were first welcomed under its slate roof, the place has aided many a recovery, including shell-shocked soldiers seeking sanctuary from first world war trenches.

And soon Winsford, at Halwill Junction near Beaworthy, will be helping people again. The disused hospital, designed by Charles Voysey as a gift from the wealthy Maria Medley to the surrounding rural communities between Dartmoor and the coast, and now being restored by the Landmark Trust, is the latest example of a growing faith in the healing powers of heritage buildings. For in the same way that walks through Britain’s forests are now being prescribed as an effective way to help counteract anxiety and stress, so the conservation trusts and charities of the heritage industry are starting to promote the power of ruins and historic buildings to improve mental wellbeing.

“It is a common theme we get back from all our stayers,” said historian Caroline Standford, of Landmark, a charity that rescues, restores and then rents out significant historic buildings. “So many say how much calmer they feel. It is so appropriate that we can use Winsford next year, because it is a place that has such a strong sense of nurturing about it.

“It is so much more welcoming than what we think of as a medical centre today. Before Voysey built it, his only cottage hospital, the villagers in the 13 surrounding rural parishes who fell ill had to travel all the way to Exeter or Okehampton.”

From next year, not only will a third of the old hospital be restored for continued use as a community health resource, but each year the remainder will be offered out at no cost for selected dates, along with some of the trust’s other buildings, as a place for those in need, including bereaved children, traumatised veterans and carers, to come and recuperate.

The ex-hospital at Winsford, Halwill Junction near Beaworthy, Devon, left, will open next year for stays to help counteract stress and anxiety. Photograph: John MIller

The scheme, called 50 for Free, has been running for five years and was inspired by the way that visitors to the trust’s buildings commented on how their mood was boosted by a stay in an ancient place, or unusual historic venue, away from the trappings of modern life. Applications for the next charitable visits open next month.

English Heritage and Historic England, two of Britain’s other major heritage and conservation charities, are also exploring the therapeutic side of their properties. English Heritage has set up days for people living with mental health problems and on low incomes at Stonehenge, a site it maintains jointly with the National Trust. Human Henge events focus on the site’s strong associations with natural healing and contemplation, much as the Japanese therapy of shinrin-yoku, or forest bathing, is now being prescribed by some doctors treating depression.

Historic England has also found that visits to historic towns, ancient places of worship and archaeological sites have the same beneficial effects on blood pressure and general wellbeing as social sporting activity.

Research by University College London five years ago was among the first to make the link between heritage sites and mental wellness. It showed that contact with a heritage site, whether as a visitor or a volunteer, frequently improved mood and even promoted a sense of citizenship among isolated and disadvantaged groups.

And this weekend, at the culmination of the annual Heritage Open Days week, many of Britain’s local authorities will be encouraging families to visit nearby museums, stately homes and historic sites as a healthy way to break the repetitive pattern of work, shopping and domestic chores.

While a period of respite in a beautiful castle or folly would probably benefit anyone, Stanford believes that Winsford, offering a moment “out of time”, with no phone or television, was always destined to be a haven of peace and healing again. Now, as the last nails are hammered in by conservationists, it is a place of restoration in both senses of the word.

Maxences des Oiseaux and Yvette Staelens with the group on the Monarch of the Plain

We held another post-project gathering at Stonehenge just after the Spring Equinox. Around 25 people came along. A walk to the Monarch of the Plain led to us standing on the barrows at either side of the west end of the cursus. Prof. Tim Darvill described how the cursus and these two barrows are aligned to the Equinox, rather than to the Solstice. There were musical conversations between flute, jaw harp and drum on top of one barrow, and Max played his swan neck flute on the Monarch of the Plain. We warmed up by a fire in a Neolithic hut, before more music and lunch in the Education Room.

This is an edited version of the report we provided to the Heritage Lottery Fund on completion of Human Henge

SUMMARY

Based at Stonehenge,
Human Henge engaged people living in Wiltshire with mental health conditions in
a creative exploration of the ancient landscape. The project began in September
2016 and ended in December 2018. A parallel research project led by Bournemouth
University addressed the question of whether Human Henge was an effective way
to improve people’s mental health and wellbeing. Evaluation by Willis Newson
considered the project’s processes and behaviours as a contribution to its
impact on participants mental health.

This evaluation and the research above concludes that Human Henge
exceeded expectations in terms of its impact on participants, partners and the
wider archive and mental health community. Overall it has been a successful
project that we hope can be a model for similar projects to take place in other
historic landscapes.

WHY HUMAN
HENGE WAS CREATED

Human Henge grew out of a conviction, shared by the partners, that
a connection with historic landscapes could play a real part in mental health
recovery. Human Henge Change Minds was intended to have heritage, social and
mental health outcomes, and as such amalgamated its partners’ concerns. English
Heritage and the National Trust are heritage organisations with social
purposes. Richmond Fellowship is a
national mental health charity with a history of using community assets including
historic landscapes for inclusion. Bournemouth University is an academic body
with a strong social purpose and local connection. The Restoration Trust is a
bridge organisation linking these outcomes, as it supports people with mental health issues to engage with heritage in order to reduce social exclusion and improve
people’s mental health.

The project
was largely funded by the Heritage Lottery Fund, but additional grants from
English Heritage and Amesbury Area Board rooted it in Stonehenge and the local
community.

Broadly,
Human Henge followed the Activity Plan we submitted with our original
application, with agreed amendments.
Funding for Human Henge Avebury extended the programme of participation
and research and in effect Human Henge at Stonehenge and Avebury became one
project. However, this evaluation report focusses on Human Henge Stonehenge.

The first
step on securing the grant was to set up a Project Board representing partners
and key stakeholders, chaired by Dr Sara Lunt, a trustee of the Restoration
Trust. Project Board meetings were well attended and often quite powerful
experiences. There was robust debate about important issues, such as the
wellbeing of participants the nature of research, ownership and rights over
local heritage, and communications strategies. Most meetings were minuted by a
Stonehenge staff member who attended for this purpose.

From the
outset we did all we could to make Human Henge as safe as possible for everyone
involved by policies and procedures which conformed to legislation and best
practice. Data protection, communications and safeguarding were key issues where we
set up policies in the preparation phase, and put them into practice in our
enrolment forms, partnership agreements and employment contracts.

Human Henge aimed to improve the health and wellbeing of people
who have mental health problems. It was not a mental health service. Although
everyone had a duty of care to participants, to behave sensibly and kindly, and
to record and share any concerns, Human Henge did not provide wider support.
This was the responsibility of Richmond Fellowship. We maintained these
boundaries in order that participants could enjoy Human Henge without feeling
that they might be treated as patients or clients. It was also an important
safety measure since mental health risk was assessed and managed by Richmond
Fellowship.

In October
2016 we offered staff and volunteers mental health first aid training delivered
by an accredited Mental Health First Aid trainer who was also a Richmond
Fellowship staff member. 16 people attended, including board members, staff and
volunteers.

The
Coordinator is an archaeology and natural voice practitioner, so she brought
heritage and creative skills to the project. Therefore, it was unnecessary for
the Richmond Fellowship Locality Manager to acquire heritage skills, and he
already had a deep interest in and knowledge of the natural world and creative
writing.

In total 32
people were recruited and 23 people attended the programme as committed
participants, i.e. they attended more than half the sessions. All these people
consented to take part in the research component of the project.

Participants
were enrolled through contact with their Richmond Fellowship support workers.
Our recruitment leaflet was designed to be as clear and informative as
possible, and also to alleviate anxiety about doing something entirely new. The
enrolment form including consent for information sharing, photography and
communications, as well as information about the participant and a wellbeing
plan. Enrolment forms were held by both Richmond Fellowship and the Restoration
Trust.

20 sessions
were held, 10 for each group, weekly on Friday mornings (10.30 – 1.30).
Transport, refreshments and materials were provided. There was no cost to
participants. Each group followed a broadly similar plan:

Human Henge was intended to be a pilot project into the efficacy of using historic landscapes for mental health, so it was essential that we had a robust evaluation strand. This fell into three categories.

Project staff – the Project Manager and
Coordinator – collected data about attendance, events, visitor numbers and so
on, for reporting outcomes at that level.

Bournemouth University were commissioned to
carry out research addressing the question: “Does a creative exploration
of historic landscape achieve sustained, measurable mental health and wellbeing
outcomes for people with mental health conditions?” Answering this was
achieved through two parallel investigations. First, a study of available literature
and published case studies was collated and published as a chapter in the
volume A handbook of well-being
edited by Kate Galvin (Darvill et al. 2018). Second was an evaluation of the
impact of the Human Henge project on the mental well-being of its participants.
This was published in two reports; firstly in June 2017, secondly in December
2018. An appendix to the final report will be produced when Human Henge Avebury
participants complete a final 1-year post project questionnaire and focus
group.

Willis Newson
were commissioned as the project’s ‘Critical Friend’/Evaluator, with a brief
to: take an observer / critical friend
role asking sometimes difficult questions; contextualise the project within
wider work taking place across the Arts and Health sector / arts on referral /
arts and health evaluation and research /good practice; signpost / make
introductions to what is going on nationally; comment on how best to make the research findings accessible and
implementable with the sector and amongst practitioners. Jane Willis’s report
on Why and How does the Human Henge
Project Support Participants Wellbeing was completed in July 2018.

Mental health
and wellbeing outcomes

In brief, outcomes are summarised below.

Bournemouth
University mental health research

It is difficult to answer the original research question “Does a creative exploration of historic
landscape achieve sustained, measurable mental health and well-being outcomes
for people with mental health conditions?” conclusively at this stage as
data collection and analysis is still ongoing. Nevertheless, findings to date
highlight that involvement in Human Henge had a positive impact upon
participants’ mental health and well-being, and to some degree this was still
apparent one year after involvement in the programme. However, caution is
required because of the relatively small sample size and the limited extent to
which it is can be said to represent the bigger picture. Accordingly, further
data collection is needed before any claims about the generality of the
findings can be made. It is proposed that a larger study, possibly with a
control group, needs to be undertaken to explore the potential of this type of
heritage programme for the health and well-being of people with mental health
conditions.

Safety and trust is built by secure partnerships and structures and good communication.

Participants are overcome challenge and risk through expert facilitation.

A sense of achievement is felt which leads to increased self-confidence and self-esteem

Positive feedback to mutual sharing enhances the sense of connectedness.

The enhanced sense of connection leads to an increased sense of safety and trust.

New risk and challenge is introduced and the cycle continues.

A deeper sense of achievement leads to increased self-esteem. Continued sharing leads to deeper connections. Deeper connection and bonding leads to an increased sense of safety.

New Economic
Foundation’s Five Ways to Wellbeing.

Take notice: the whole group has an intense sensory experience of the landscape.

Be active: people get out and about, walking further and more confidently session by session.

Connecting: people connect across deep time, with the place they live, and with each other.

Learn: archaeology, creativity, nature, knowing a place. How to be with a group.

Give: the group shares the experience. People help each other in practical ways.

Research methodology

Human Henge research by Bournemouth University comprised a
mixed-methods approach summarized schematically below. The process was reviewed
and approved prior to the start of the first programme in line with Bournemouth
University Research Ethics Code of Practice.

It was important to capture both quantitative and qualitative data
because the sample size was small and, whilst interesting, means that
conclusions derived from the evaluation so far have limited generality. At the
start of each delivery of the Human Henge programme the participants completed
a baseline questionnaire capturing their thoughts and feelings towards the
project. The Short Warwick Edinburgh Mental Wellbeing Scale (Tennant et al.
2007) was used to measure their mental wellbeing, supplemented by questions
regarding their interests in history, heritage, and archaeology (see Table 2).
The same questionnaire was repeated in the middle and at the end of each
10-week programme, and again for a final time in 2018 a year after the sessions
finished. Quantitative data was analysed using descriptive and inferential
statistics as well as content analysis, qualitative data from the evaluation
was analysed thematically using the Braun and Clarke (2006) process of thematic
analysis.

Participants are involved in management. One participant became a member of the Change Human Henge Project Board, 8 contributed to a Sharing Event and 4 attended a Restoration Trust Participants Council. The Project Board included a Patient Public Involvement member.

Partnership with heritage and health organisations. The partnership between the Restoration Trust (RT), English Heritage, Richmond Fellowship and Bournemouth was confirmed in a signed partnership agreement which stated that the partners would deliver the project according to our application to Heritage Lottery Fund. All partners are members of the Project Board. Contributing organisations, including the National Trust, Avon and Somerset NHS Partnership Trust are represented on the Project Board.

Groupwork is the core. All sessions were group sessions and informed by relevant theory and practice. They were based on the view that lasting change can occur within a carefully conducted group.

Safe framework and practice. The partners’ policies and practices meet the required standards, and due diligence was applied when forming the partnership. Staff and volunteers worked to relevant professional standards and, if it was required for their role, had external validation of their suitability to work with vulnerable people by showing evidence that they have Enhanced Disclosure and Barring Service Certificate (DBS).

Proper measurement of impact and outcomes. Research by Bournemouth University and Willis Newson. Ethical approval by Bournemouth University Ethics Committee. Participants were recruited as Richmond Fellowship clients rather than NHS patients so research did not need NHS ethics approval

Sustained and regular involvement. 10 weekly sessions. Three workshop sessions after the project ended. Ongoing informal connections between people and through the Humans of Stonehenge private facebook group. Richmond Fellowship ongoing history projects, including visits to Wiltshire Museum, and a series of workshops at Salisbury Cathedral.

Resources. We needed
to allow more time and money for project management and digital engagement. As
a small organisation whose backroom activities are funded through projects, we
need more unrestricted funding to maximize the impact of this high-profile
project. Our Chair devoted more pro-bono time to the project than she had
anticipate

The demands
of the site. The immense benefit of running a project at
Stonehenge in terms of public and professional attention was matched by the
need for attentive management of the delicate balances required in dealing with
conflicting interests at a contested site. We were not always successful in
negotiating these tricky waters, and indeed they were not really our business.
However they sometimes impacted on the project, or rather they demanded more
time than we had allocated for project management.

Partnership. The
Restoration Trust is a small organisation managing a complex partnership of
much bigger organisations, some of whom have competing interests.

Cuts to
services and contracts. The Richmond Fellowship’s outreach and
inclusion contracts have been reduced since the project began, and this has
made it more difficult for the Locality Manager to provide staff resources to
support people to attend follow-on activities.

Mental health
discrimination. There is a level of unconscious
discrimination against people with serious mental health problems which is
manifest by partner organisations and professionals in unexpected ways.
Excessive anxiety about what people might do on site, or how to cope if they
became unwell reflect wider societal attitudes. Participants were sometimes
surprised and disconcerted by views expressed by volunteers, staff, students
and the general public.

Ending the
programme. The ending of the programme was experienced
as a considerable loss, as it was rather abrupt. As a result we gained funding
to run three follow-on sessions, which have been successful gatherings of Human
Hengers at local heritage venues (Ancient Technology Centre, Wiltshire Museum,
Stonehenge Stone Circle in March 2019).

CONCLUSION

Overall Human Henge has been a successful
project, with benefits for participants, partners, stakeholders and the local
and professional community that went beyond our expectations. It justified our
original supposition that walking with intent in ancient landscapes has the
potential to support the recovery of people with complex mental health needs,
although research outcomes are not conclusive. However the enthusiasm with
which Human Henge was received by both heritage and health professionals shows
that imaginative use of heritage landscapes can make a profound difference to
individuals, and we hope also to mental health and heritage policy and practice
at local and national levels.

We are very grateful to our partners, staff,
volunteers, researchers, board members, local media and national media, and
those who visited Human Henge exhibitions and events. We thank the Heritage Lottery Fund for their
grant, which enabled the project to take place. Our foremost thanks go to all
the Human Hengers, who through their courage and commitment turned the idea of
a creative exploration of historic landscapes into a powerful experience for
everyone involved.

Wayfaring is a journey of exploration, inspired by the present landscape and ancient routes of the Icknield Way.

The culmination of our groundbreaking Lifecycles and Landscapes project. Artists And Now: will create a series of artworks in Areas of Outstanding Natural Beauty inviting audiences to think about movement and migration; how we arrive at, understand, inhabit, protect and leave a space.

Using local and found materials the artists will craft an installation on Maiden Castle which audiences can move through, investigate and contribute to. On the final weekend fire illumination, music and performance will transform the installation into an intimate celebration.

The Wayfaring digital artwork, an evolving sketchbook of observations and learnings created by And Now: that compliments the live work can be found here.